Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery

Helena Amstrup Jensen; Torsten Grønbech Nielsen; Martin Lind

doi:10.1186/s10195-024-00759-1

Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery

Helena Amstrup Jensen^*, Torsten Grønbech Nielsen, Martin Lind

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: The objective of this study is to investigate the risk of revision surgery when delaying anterior cruciate ligament reconstruction (ACLR) past 3 months or 6 months after injury.

MATERIALS AND METHODS: A total of 30,280 patients with isolated ACLR were identified in the Danish Knee Ligament Reconstruction Registry and divided into four groups; ACLR < 3 months, > 3 months, < 6 months, or > 6 months after injury. Primary outcome was revision surgery and secondary outcome were objective and subjective clinical outcome. The 2 year relative risk, crude, and adjusted hazard ratio (HR) were calculated.

RESULTS: Comparing ACLR < 3 months to ACLR > 3 months of injury the 2 year relative risk of revision surgery was found to be 1.81 (95% CI 1.46-2.23; P < 0.001) with an adjusted hazard ratio (HR) of 1.27 (95% CI 1.12-1.44; P < 0.001). Comparing ACLR < 6 months to ACLR > 6 months of injury the 2 year relative risk of revision surgery was found to be 1.61 (95% CI 1.34-1.92; P < 0.001) with an adjusted HR of 1.27 (95% CI 1.15-1.40; P < 0.001).

CONCLUSION: The risk of revision ACLR surgery was found to be increased when ACLR was performed within 3 months or 6 months of injury compared with later surgery. The 1 year postoperative objective knee laxity and the subjective patient-related outcome was found to be without a clinically significant difference; however, those with early ACLR (< 3 months or < 6 months) were found to have a higher activity level 1 year postoperatively. The information about increased risk of revision when having early surgery should be informed to patients when deciding timing of ACLR treatment.

LEVEL OF EVIDENCE: II.

Original language	English
Article number	19
Journal	Journal of Orthopaedics and Traumatology
Volume	25
Issue	1
ISSN	1590-9921
DOIs	https://doi.org/10.1186/s10195-024-00759-1
Publication status	Published - 18 Apr 2024

Keywords

ACL
ACL reconstruction
ACL reconstruction revision
Anterior cruciate ligament reconstruction
Revision surgery
Time from injury to surgery
Timing
Reoperation
Anterior Cruciate Ligament Injuries/surgery
Knee Joint/surgery
Humans
Anterior Cruciate Ligament Reconstruction/methods
Ligaments, Articular/surgery

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10.1186/s10195-024-00759-1

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@article{15137854e4004247a33388490b29c2a9,

title = "Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery",

abstract = "BACKGROUND: The objective of this study is to investigate the risk of revision surgery when delaying anterior cruciate ligament reconstruction (ACLR) past 3 months or 6 months after injury.MATERIALS AND METHODS: A total of 30,280 patients with isolated ACLR were identified in the Danish Knee Ligament Reconstruction Registry and divided into four groups; ACLR < 3 months, > 3 months, < 6 months, or > 6 months after injury. Primary outcome was revision surgery and secondary outcome were objective and subjective clinical outcome. The 2 year relative risk, crude, and adjusted hazard ratio (HR) were calculated.RESULTS: Comparing ACLR < 3 months to ACLR > 3 months of injury the 2 year relative risk of revision surgery was found to be 1.81 (95% CI 1.46-2.23; P < 0.001) with an adjusted hazard ratio (HR) of 1.27 (95% CI 1.12-1.44; P < 0.001). Comparing ACLR < 6 months to ACLR > 6 months of injury the 2 year relative risk of revision surgery was found to be 1.61 (95% CI 1.34-1.92; P < 0.001) with an adjusted HR of 1.27 (95% CI 1.15-1.40; P < 0.001).CONCLUSION: The risk of revision ACLR surgery was found to be increased when ACLR was performed within 3 months or 6 months of injury compared with later surgery. The 1 year postoperative objective knee laxity and the subjective patient-related outcome was found to be without a clinically significant difference; however, those with early ACLR (< 3 months or < 6 months) were found to have a higher activity level 1 year postoperatively. The information about increased risk of revision when having early surgery should be informed to patients when deciding timing of ACLR treatment.LEVEL OF EVIDENCE: II.",

keywords = "ACL, ACL reconstruction, ACL reconstruction revision, Anterior cruciate ligament reconstruction, Revision surgery, Time from injury to surgery, Timing, Reoperation, Anterior Cruciate Ligament Injuries/surgery, Knee Joint/surgery, Humans, Anterior Cruciate Ligament Reconstruction/methods, Ligaments, Articular/surgery",

author = "Jensen, {Helena Amstrup} and Nielsen, {Torsten Gr{\o}nbech} and Martin Lind",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = apr,

day = "18",

doi = "10.1186/s10195-024-00759-1",

language = "English",

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Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery. / Jensen, Helena Amstrup; Nielsen, Torsten Grønbech ; Lind, Martin.
In: Journal of Orthopaedics and Traumatology, Vol. 25, No. 1, 19, 18.04.2024.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery

AU - Jensen, Helena Amstrup

AU - Nielsen, Torsten Grønbech

AU - Lind, Martin

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/4/18

Y1 - 2024/4/18

N2 - BACKGROUND: The objective of this study is to investigate the risk of revision surgery when delaying anterior cruciate ligament reconstruction (ACLR) past 3 months or 6 months after injury.MATERIALS AND METHODS: A total of 30,280 patients with isolated ACLR were identified in the Danish Knee Ligament Reconstruction Registry and divided into four groups; ACLR < 3 months, > 3 months, < 6 months, or > 6 months after injury. Primary outcome was revision surgery and secondary outcome were objective and subjective clinical outcome. The 2 year relative risk, crude, and adjusted hazard ratio (HR) were calculated.RESULTS: Comparing ACLR < 3 months to ACLR > 3 months of injury the 2 year relative risk of revision surgery was found to be 1.81 (95% CI 1.46-2.23; P < 0.001) with an adjusted hazard ratio (HR) of 1.27 (95% CI 1.12-1.44; P < 0.001). Comparing ACLR < 6 months to ACLR > 6 months of injury the 2 year relative risk of revision surgery was found to be 1.61 (95% CI 1.34-1.92; P < 0.001) with an adjusted HR of 1.27 (95% CI 1.15-1.40; P < 0.001).CONCLUSION: The risk of revision ACLR surgery was found to be increased when ACLR was performed within 3 months or 6 months of injury compared with later surgery. The 1 year postoperative objective knee laxity and the subjective patient-related outcome was found to be without a clinically significant difference; however, those with early ACLR (< 3 months or < 6 months) were found to have a higher activity level 1 year postoperatively. The information about increased risk of revision when having early surgery should be informed to patients when deciding timing of ACLR treatment.LEVEL OF EVIDENCE: II.

AB - BACKGROUND: The objective of this study is to investigate the risk of revision surgery when delaying anterior cruciate ligament reconstruction (ACLR) past 3 months or 6 months after injury.MATERIALS AND METHODS: A total of 30,280 patients with isolated ACLR were identified in the Danish Knee Ligament Reconstruction Registry and divided into four groups; ACLR < 3 months, > 3 months, < 6 months, or > 6 months after injury. Primary outcome was revision surgery and secondary outcome were objective and subjective clinical outcome. The 2 year relative risk, crude, and adjusted hazard ratio (HR) were calculated.RESULTS: Comparing ACLR < 3 months to ACLR > 3 months of injury the 2 year relative risk of revision surgery was found to be 1.81 (95% CI 1.46-2.23; P < 0.001) with an adjusted hazard ratio (HR) of 1.27 (95% CI 1.12-1.44; P < 0.001). Comparing ACLR < 6 months to ACLR > 6 months of injury the 2 year relative risk of revision surgery was found to be 1.61 (95% CI 1.34-1.92; P < 0.001) with an adjusted HR of 1.27 (95% CI 1.15-1.40; P < 0.001).CONCLUSION: The risk of revision ACLR surgery was found to be increased when ACLR was performed within 3 months or 6 months of injury compared with later surgery. The 1 year postoperative objective knee laxity and the subjective patient-related outcome was found to be without a clinically significant difference; however, those with early ACLR (< 3 months or < 6 months) were found to have a higher activity level 1 year postoperatively. The information about increased risk of revision when having early surgery should be informed to patients when deciding timing of ACLR treatment.LEVEL OF EVIDENCE: II.

KW - ACL

KW - ACL reconstruction

KW - ACL reconstruction revision

KW - Anterior cruciate ligament reconstruction

KW - Revision surgery

KW - Time from injury to surgery

KW - Timing

KW - Reoperation

KW - Anterior Cruciate Ligament Injuries/surgery

KW - Knee Joint/surgery

KW - Humans

KW - Anterior Cruciate Ligament Reconstruction/methods

KW - Ligaments, Articular/surgery

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U2 - 10.1186/s10195-024-00759-1

DO - 10.1186/s10195-024-00759-1

M3 - Journal article

C2 - 38637340

AN - SCOPUS:85190682283

SN - 1590-9921

VL - 25

JO - Journal of Orthopaedics and Traumatology

JF - Journal of Orthopaedics and Traumatology

IS - 1

M1 - 19

ER -

Delaying anterior cruciate ligament reconstruction for more than 3 or 6 months results in lower risk of revision surgery

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